高渗葡萄糖关节盘后附着注射治疗TMD慢性关节痛临床观察  

Hypertonic dextrose injection in retrodiscal tissue attachment for the management of chronic joint pain in patients with TMD

作　　者：张泽玮 刘平 薛洋 周宏志 ZHANG Zewei;LIU Ping;XUE Yang;ZHOU Hongzhi(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Clinical Research Center for Oral Diseases,Department of Oral and Maxillofacial Surgery,The Third Hospital Affiliated of Air Force Military Medical University,710032 Xi'an,China)

机构地区：[1]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,空军军医大学第三附属医院口腔颌面外科,西安710032

出　　处：《实用口腔医学杂志》2024年第2期252-256,共5页Journal of Practical Stomatology

摘　　要：目的:观察高渗葡萄糖关节盘后附着注射(增生疗法)治疗颞下颌关节紊乱病(TMD)慢性关节痛的疗效。方法:2012年6月起纳入患者244例(16~75岁),按照DC/TMD标准分类。于关节盘后附着处,注射利多卡因1.5~2 mL,张闭口活动5~10 min,同法注射50%葡萄糖1.5~2 mL。治疗后2周、2月、6月、12月定期复诊,2023年3月终期随访。结果:终期完成随访221例(失访率9.4%),平均随访时间(75.7±25.1)月。治疗后2周患者即可有关节痛明显缓解,2月时多数患者张口/咀嚼功能明显改善,随后复查多数患者保持稳定恢复。186例经注射治疗后疼痛基本消失、张口/咀嚼功能基本正常,17例后期有张口/咀嚼功能障碍和关节痛复发表现,由于有注射恐惧改为接受咬合垫治疗,16例述注射治疗无明显效果,但也未再作其他治疗,2例后续接受手术治疗。无病例出现治疗后疼痛加重或其他并发症。结论:关节盘后附着注射高渗葡萄糖治疗TMD及慢性关节痛简单易行,安全有效。Objective:To observe the efficacy of hypertonic dextrose injection(prolotherapy)at retrodiscal tissue in the treatment of chronic joint pain in patients with temporomandibular disorders(TMD).Methods:From June 2012 to March 2022,244 patients(aged 16 to 75 years)underwent the treatment were included and classified according to DC/TMD.The treatment started from an anesthetic injection of 2%lidocaine(1.5-2 mL)into the retrodiscal tissue.The patients were then instructed to perform mandibular condylar exercise for 5-10 min,prior to the therapeutic injection of 50%dextrose(1-1.5 mL)by using the same method.Assessment of TMJ pain and jaw function was performed at 2 weeks,2,6 and 12 months after injection.Results:By March 2022,221 cases completed the final survey(the rate of loss of follow-up was 9.4%),the average follow-up time was(75.7±25.1)months.2 weeks after treatment,there was significant relief of joint pain,and mandibular function was significantly improved in most patients by 2 month after treatment.Of these,186 cases achieved profound pain relief and faily normal jaw function,17 cases with recurrence of joint pain and jaw dysfunction and opted for occlusal splint treatment due to fear of injection,16 cases claimed no obvious therapeutic effect but rejected any further tratment,2 cases subsequently accepted TMJ surgery.There was no worsening of TMD or other complication as a result of the treatment.Conclusion:Hypertonic dextrose injection in retrodiscal tissue attachment is straightforward,safe and effective in the treatment of chronic joint pain and TMD.

关 键 词：颞下颌关节紊乱病 慢性关节痛 关节盘后附着 高渗葡萄糖 增生疗法 

分 类 号：R782.6[医药卫生—口腔医学]